A nurse is talking to a client who expresses frustration regarding her scheduled care.
Which of the following actions by the nurse promotes client autonomy?
Telling the client to rest before performing morning care.
Asking the client to choose the order of care activities.
Setting up the client's bath supplies for later use.
Informing the client that the hospital schedule must be followed.
The Correct Answer is B
Choice A rationale
Telling the client to rest before care is an example of paternalism, where the nurse makes a decision for the client based on what the nurse believes is best. This overrides the client's right to self-determination and does not address the client's expressed frustration regarding their care. Autonomy requires that the client be the primary decision-maker in their own life. Restricting their activity without their input can lead to a loss of control and increased patient dissatisfaction.
Choice B rationale
Allowing the client to choose the order of care activities directly promotes autonomy by giving the individual control over their daily routine and environment. Autonomy is the ethical principle that recognizes the right of a person to make their own choices and take actions based on their personal values and beliefs. By involving the client in the scheduling process, the nurse empowers them, reduces feelings of helplessness, and fosters a collaborative relationship that respects the client's preferences.
Choice C rationale
Setting up supplies for later use is a task-oriented action that may be helpful for efficiency but does not necessarily involve the client in the decision-making process. If the nurse decides when "later" is without consulting the client, it is still a nurse-driven schedule rather than a client-driven one. While it prepares for future care, it fails to provide the client with a meaningful opportunity to exercise their right to choose or to influence the timing of their interventions.
Choice D rationale
Informing the client that a hospital schedule must be followed is a rigid approach that prioritizes institutional needs over the individual rights of the patient. This type of communication stifles autonomy and can lead to a breakdown in the therapeutic relationship. While some schedules are necessary for hospital operations, many nursing care activities can be adjusted to accommodate patient preferences. Insisting on a strict schedule without flexibility ignores the ethical duty to respect the client's self-governance.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Listing completed sessions is a simple reporting of attendance or participation in educational activities. This is a factual statement of record rather than a reflective process. Reflection requires the nurse to look back on their performance, identify gaps in their knowledge or skills, and determine what is needed for future growth. Simply stating that three ECG sessions were completed does not demonstrate an internal assessment of competence or a desire for further clinical improvement.
Choice B rationale
This statement demonstrates self-reflection because the nurse has evaluated their own clinical performance and identified a specific area where they lack confidence or proficiency. By requesting more practice, the nurse shows an understanding of their current limitations and a proactive commitment to achieving clinical mastery. Self-reflection is a critical component of professional development, involving a conscious effort to think about one's actions and experiences to improve future outcomes and ensure patient safety.
Choice C rationale
Assisting with the implementation of a new system is a task-oriented achievement and a contribution to the facility's operations. While it shows participation and perhaps leadership, it is an objective description of work performed rather than an introspective analysis of one's own nursing practice. Reflection involves looking inward at one's personal development and clinical judgment, whereas implementing a system is an external administrative or clinical task that does not necessarily require the nurse to evaluate themselves.
Choice D rationale
Punctuality is a basic professional expectation and a measurable behavior related to work habits. Recording that one arrived on time for all shifts is a statement of compliance with workplace policies. It does not involve the deeper cognitive process of examining one's clinical decisions, emotional responses to patient care, or the identification of professional strengths and weaknesses. Reflection goes beyond administrative compliance to focus on the quality and evolution of the nurse's clinical practice and identity.
Correct Answer is C
Explanation
Choice A rationale
Disclosing a nurse's past academic misconduct to other staff members is a violation of privacy and can create a hostile work environment. Professional ethics and legal standards require that personnel information remain confidential between the employee and management. Labeling a nurse to their peers based on a personal reference can damage professional relationships before they begin. The manager must maintain a professional atmosphere that allows the nurse to demonstrate their current level of integrity and skill.
Choice B rationale
The risk manager is typically involved when an actual incident or legal liability occurs within the facility. Plagiarism in nursing school is an academic integrity issue that happened prior to employment and does not automatically constitute a current clinical risk. While the manager should be aware of the history, involving the risk manager at this stage is premature. The focus should be on internal monitoring and professional development within the nursing department rather than administrative legal escalation.
Choice C rationale
Monitoring documentation is a proactive and objective way to ensure professional integrity and patient safety without violating the nurse's rights. Documentation is a legal record of care, and ensuring its accuracy is a primary responsibility of the nurse manager. High acuity times are when stress is greatest and shortcuts are most likely to be taken. This action allows the manager to verify that the nurse is practicing honestly and meeting the required standards of professional conduct.
Choice D rationale
Rescinding a job offer based solely on a personal reference regarding past academic behavior may lead to legal challenges if not handled correctly. While academic integrity is important, the manager has already made a hiring decision based on the candidate's qualifications and interview. Unless the plagiarism resulted in a loss of licensure or was a falsification of the employment application itself, it may not be grounds for immediate termination. The manager should instead focus on current performance and ethical practice.
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